A tuberculosis spondylitis patient with paraplegic manifestations

Abstract

Background: Mycobacterium tuberculosis is the primary causative agent of tuberculous spondylitis (TB spondylitis), a chronic granulomatous inflammatory disease of the spine. Patients with TB spondylitis may have spinal lesions in up to 50% of cases, and 10-45% may also have neurological deficits. We reported a case of severe paraplegia manifesting TB spondylitis in a young adult patient. Case Presentation: A 28-year-old female Javanese Muslim was admitted to Dr. Soetomo General Academic Hospital in Surabaya, Indonesia with back pain, inability to move, and feeling stiff in both legs. During previous therapy, the patient was thought to have spondyloarthropathy. X-ray examination demonstrated T9 to T10 retrolisthesis and T10 corpus lipping. Thoracolumbosacral MRI with contrast revealed that the patient had TB spondylitis. A debridement and hemilaminectomy of T7-8 for fusion with bone segments at T7-8 were performed on the patient. The patient was treated with oral antituberculosis drugs for 10 months and could walk perfectly 8.5 months after the initial treatment. Conclusion: This case demonstrates the complexities of diagnosing TB spondylitis, which necessitates the use of multiple disciplines. Because the clinical manifestations of TB spondylitis differ, various methods, including thoracolumbosacral X-ray and MRI with contrast, are required to confirm the disease. As a result, an interdisciplinary collaborative team is required to achieve optimal patient outcomes and to prevent long-term sequalae.